The relationship between mean pulmonary artery pressure and quality of life in patients with mitral stenosis.

OBJECTIVES: We aimed to evaluate echocardiography-guided hemodynamic determinants of quality of life (QoL) via the Medical Outcomes Study Short Form (SF-36) questionnaire in patients with mild to moderate mitral stenosis (MS). METHODS: Eighty consecutive patients with rheumatic MS, who were admitted to the outpatient department, were enrolled into the study upon obtaining informed consent. Forty age-sex-matched healthy individuals were enrolled as a control group. RESULTS: All subscale scores and total SF-36 scores were significantly lower in the patient group representing a worse QoL. In multivariable logistic regression analysis, only mean pulmonary artery pressure (OR 1.138, 95% CI 1.049-1.234, p = 0.002) was found to be an independent predictor of poor QoL in patients with mild to moderate MS. CONCLUSION: During follow-up of MS patients before intervention, physicians should consider that mean pulmonary artery pressure is the main factor which influences the patients' QoL. In patients with MS, it seems that referral to intervention should consider components and derivatives of QoL.

Anxiety, depression and functional capacity in older women with mitral valve stenosis.

Mitral valve stenosis can lead to a range of symptoms that affect daily life. As many of the people with this problem are elderly, the difficulties resulting from age can be exacerbated by illness. A pilot descriptive study was designed to examine the differences in anxiety, depression and functional capacity in women with mitral valve stenosis who were aged over 60 years when compared to a similar group of volunteers who did not have any cardiac disease. Measurement was undertaken using the Hospital Anxiety and Depression scale, the SF-36 Health Status questionnaire and the Functional Limitations Profile. Forty women were recruited to the study: 20 women with mitral valve stenosis and 20 volunteers. Each person was asked to complete the three questionnaires on one occasion only. Non-parametric statistics were used for analysis. Patients fared worse than volunteers with significant differences between groups in respect of anxiety (P = 0.03), depression (P = 0.02) and overall function (P < 0.001), but not in physical (P = 0.52) or mental health (P = 0.32). Future research could focus on strategies that would help alleviate anxiety and depression and improve functional capacity in older women with mitral valve stenosis.

[Fundamentals and indications for mitral valve repair surgery]. / Fondements et indications de la chirurgie réparatrice dans les valvulopathies mitrales.

The concept of mitral valve repair is discussed, emphasizing the basic knowledge on which it relies, and the breakthrough it has produced in modern cardiac surgery. This concept challenges the myth of the artificial prosthesis, showing the superiority of autologous biological structures submitted to plastic repair. The foundations of valvular repair and the techniques that have contributed to its success are reviewed, and the advantages for the patients in terms of quality of life, and preservation of the left ventricular function are discussed.

Behavioral disturbance, embolism, and mitral stenosis.

The hypothesized equivalence of behavioral disturbances (BD) and embolic (E) events in predicting subsequent events in mitral stenosis patients was tested by a retrospective comparison of clinical courses. Behavioral disturbances, presenting in twenty patients, were followed by 9.6 BD, 13.8 E, and 5.3 fatal events per 100 patient years. Embolic events, presenting in thirty-three patients, were followed by 1.9 BD, 8.4 E, and 3.4 fatal events per 100 patient years. Forty-six patients presenting with neither event subsequently had 2.7 BD, 7.3 E, and 3.6 fatal events per 100 patient years. It is concluded that a behavioral disturbance in the setting of mitral stenosis is a predictive of an embolic event as is an embolic event itself.